Surgery – Instruments – Orthopedic instrumentation
Reexamination Certificate
1999-09-22
2001-07-17
Mancene, Gene (Department: 3732)
Surgery
Instruments
Orthopedic instrumentation
C606S170000
Reexamination Certificate
active
06261294
ABSTRACT:
BACKGROUND OF THE INVENTION
The invention relates to a sliding-shaft medical instrument having a sliding shaft that has first and second slide elements, arranged side by side and displaceable relative to one another, having at least one jaw part at a distal end of the sliding shaft, that is actuable, by way of a handle at a proximal end, via a relative displacement of the first and second slide elements, the handle having two handle elements that are movable relative to one another.
A sliding-shaft instrument of this kind is known from DE-A-41 15 937.
A further sliding-shaft instrument of this kind is known from the company brochure of Karl Storz GmbH & Co., Tuttlingen, Germany, entitled “Karl Storz-Endoskope” [Karl Storz endoscopes], section entitled “Instrumente fŸr Nase und Nasenplastik” [Instruments for the nose and rhinoplasty], page N 10 A.
Sliding-shaft instruments are used in endoscopic surgery for surgical operations of various kinds in the human or animal body, sliding-shaft instruments being particularly suitable for transferring large forces even in confined spaces, for example between vertebrae.
The sliding-shaft instrument known from the aforesaid company brochure has a sliding shaft that has two slide elements, arranged side by side and displaceable relative to one another. The one, immovable sliding element is joined immovably to the immovable handle element, while the other slide element is joined displaceably and directly to the movable handle element of the handle at the proximal end. Actuation of the handle causes the movable slide element to be displaced relative to the immovable slide element, so that a jaw part at the distal end of the sliding-shaft instrument can be actuated, for example to detach or grasp tissue.
A disadvantage of the known sliding-shaft instrument, however, consists in the fact that it can be disassembled into its components only inadequately, or at least only with great time expenditure, so cleaning of the sliding-shaft instrument presents difficulties. In particular, contaminants collect between the two slide elements, i.e. more precisely between the mutually contacting sliding surfaces of the two slide elements. In the known sliding-shaft instrument, the region between the slide elements is not accessible, so that it is impossible to guarantee that contaminants between the slide elements can be reliably eliminated.
In the case of longer instruments, however, especially for endoscopically assisted abdominal cavity surgery, it is absolutely necessary that the sliding-shaft instrument be easy to clean.
The sliding-shaft instrument known from the aforesaid DE-A-41 15 937 has a sliding shaft that is also directly joined to the handle. The sliding shaft is configured so that the two slide elements forming the sliding shaft can be separated from one another for easier cleaning once the sliding shaft has been taken off the handle, but this known sliding-shaft instrument is disadvantageous for the following reasons:
In endoscopically assisted operations, the necessary instruments are often inserted through a trocar which presents an opening having a circular cross section. Since a positive pressure is generated in order to make the surgical field accessible, any such instrument in the trocar must seal as tightly as possible and also be securely guided by the trocar.
The aforesaid known sliding-shaft instrument does not guarantee such sealing closure in a trocar, since the sliding shaft extends as far as the handle, and thus upon insertion into a trocar, a positive pressure that has been established in the surgical field can escape outward between the two slide elements that are arranged side by side. A further disadvantage when the known instrument is used with a trocar consists in the fact that one of the two slide elements is in frictional contact with the trocar when the instrument is actuated therein.
Also known, from DE Utility Model 94 21 125, is a surgical forceps that is not a sliding-shaft instrument as defined by the present invention, but rather a tubular-shaft instrument whose tubular shaft has a longitudinal slot in which is guided an actuation rod that is axially movable in the longitudinal slot and is joined at the distal end to a jaw part in order to move it. This tubular-shaft instrument also does not guarantee sealed closure in a trocar, since in this case a positive pressure can escape through the longitudinal slot in the tubular shaft.
A conventional tubular-shaft instrument having a closed tubular shaft is known from DE Utility Model 17 12 028, but it is not a sliding-shaft instrument.
It is therefore the object of the invention to develop a sliding-shaft instrument of the kind cited initially in such a way that it can easily be cleaned and made sterile, and so as to ensure that contaminants on the components, in particular between the slide elements, can be eliminated. An instrument of this kind is moreover intended to ensure the sealing tightness of a trocar through which it is introduced, and to be securely guided and held by the trocar.
SUMMARY OF THE INVENTION
This object is achieved, in terms of the sliding-shaft instrument cited initially, in that the sliding shaft is arranged at the distal end of an elongated tubular shaft that is attached detachably to the handle; that the first slide element is mounted at the distal end of the tubular shaft in swing-aside fashion, that in order to actuate the at least one jaw part, the tubular shaft is displaceable, together with the first slide element, relative to the second slide element, and that the first slide element can be swung aside when the tubular shaft is detached from the handle and is displaced a further distance with respect to the second slide element.
The configuration of the sliding-shaft instrument according to the present invention allows easy and rapid disassembly of the sliding-shaft instrument, and moreover guarantees the requisite sealing tightness and guidance when working through a trocar. Because a tubular shaft is provided between the slide elements and the handle, the instrument fits in secure and sealed fashion into a (usually cylindrical) trocar. Because the first slide element of the sliding shaft is mounted at the distal end of the tubular shaft in swing-aside fashion, the first slide element can be folded out with respect to the second slide element for cleaning of the sliding-shaft instrument, so that the region between the two slide elements is easily accessible for cleaning. Cleaning of the slide elements thus requires simply folding them out away from one another. Since this first slide element is mounted at the distal end of the tubular shaft in swing-aside fashion, provision is furthermore made, according to the present invention, for the tubular shaft to be displaced by way of the handle in order to actuate the at least one jaw part, thus bringing about the relative displacement of the two slide elements, since the first slide element is joined to the tubular shaft. The configuration of the tubular shaft displaceably, according to the present invention, has the advantage that the sliding-shaft instrument can be equipped with a handle such as the one known as the “Take Apart” handle of Karl Storz GmbH, Tuttlingen, Germany, which has proven very successful for medical forceps. Another provision according to the present invention is for the tubular shaft to be detachable from the handle, thus allowing further disassembly of the sliding-shaft instrument. Because the first sliding element can be swung aside only when the tubular shaft is detached from the handle, the result is that the two sliding elements do not fold out away from one another when the sliding-shaft instrument is being used for surgery. Altogether, the invention makes available a sliding-shaft instrument which can be easily and quickly disassembled to the point that the individual components of the sliding-shaft instruments can easily be cleaned, and that all components are accessible for cleaning to such an extent that contaminants can reliably be remo
Efinger Andreas
Stihl Ewald
Bumgarner Melba
Karl Storz GmbH & Co. KG
Mancene Gene
St. Onge Steward Johnston & Reens LLC
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